A retrospective survey of dengue virus infection in fatal cases from an epidemic in Brazil.
Dengue virus can infect many cell types from the vascular, muscular and hematological systems causing diverse clinical and pathological signs. The purpose of the present study was to investigate by different diagnostic methods dengue virus in human tissue specimens obtained from fatal cases (n=29) during a large-scale dengue fever epidemic in 2002 in the State of Rio de Janeiro, Brazil. The combination of four procedures provided diagnostic confirmation of DENV-3 infection in 26 (89.6%) out of the 29 suspected fatal cases. Dengue virus (DENV) was isolated from 2/74 (2.7%) tissue samples, inoculated into C6/36 cells and identified as DENV-3, nested RT-PCR accusing 22/72 (30.5%) samples as DENV-3. Real-time RT-PCR yielded the highest positivity rate, detecting viral RNA in 45/77 (58.4%) clinical specimens, including the liver (n=18), lung (n=8), spleen (n=8), brain (n=6), kidney (n=3), bone marrow (n=1) and heart (n=1). Immunohistochemical tests recognized the DENV antigen in 26/59 (44%) specimens. Given the accuracy and effectiveness of real-time RT-PCR in this investigation, this approach may play an important role for rapid diagnosis of dengue infections.
de Araújo
Josélio M Galvão
JM
Laboratory of Flavivirus, Oswaldo Cruz Institute, Rio de Janeiro, Brazil. joselio@ioc.fiocruz.br
Schatzmayr
Hermann Gonçalves
HG
de Filippis
Ana Maria Bispo
AM
Dos Santos
Flávia Barreto
FB
Cardoso
Maria Angélica
MA
Britto
Constança
C
Coelho
Janice M C Oliveira
JM
Nogueira
Rita Maria Ribeiro
RM
D000956:Antigens, Viral / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D003715:Dengue / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality* / Q000821:virology; D003716:Dengue Virus / Q000235:genetics / Q000302:isolation & purification*; D004196:Disease Outbreaks; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D007668:Kidney / Q000821:virology; D008168:Lung / Q000821:virology; D012367:RNA, Viral / Q000032:analysis / Q000302:isolation & purification; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D013154:Spleen / Q000821:virology
D000956:Antigens, Viral; D012367:RNA, Viral